| NPI | 1619117058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ALLEN LONESKY Do/Owner 304-415-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2023-04-28 |